Resorption Flashcards
What is root resoprtion?
Root resorption is the non-microbial destruction of the dental hard and soft tissue, due to the interaction of clastic cells.
What is the function of RANKL in bone resorption?
Stimulates osteoclastic activity, and therefore stimulates bone loss.
What can stimulate RANKL production?
Parathyroid hormone
Bacterial LPS
Trauma (physical/mechanical)
Chronic inflammation
What are the types of internal root resorption?
Inflammatory
Replacement
What is inflammatory internal root resorption?
Increased size of pulp chamber or canal
Pulp tissue becomes enlarged due to inflammation
Dental hard tissue breaks down from inside out
What is internal replacement resorption?
Deposition of hard tissue within pulpal space, after an inital inflammatory response.
Describe the pathogenesis of internal inflammatory resorption?
Coronal portion of pulp is necrotic
Apical portion of pulp is vital
Pulp will inflame and spread outwards
Eventually entire pulp will become necrotic
(Can communicate with PDL if perforation is present)
What are the treatment options for IRR?
XLA or Endo
If endo:
- Expect haemorrhage
- Use active irrigation
- Use intervisit medicament
- Use thermal obturation
What are the treatment options for internal replacement resorption?
Leave or XLA
Too difficult to endodontically treat unless mild.
What types of external root resorption are there?
Surface
Inflammatory
Cervical
Replacement
What is the aetiology of external surface resorption?
Orthodontics
Ectopic teeth
Pathological lesions
Idiopathic
Should endodontics be carried out on all teeth with external surface resorption?
If the pulp is healthy, then there is no indication to. This treatment will not have any effect.
What is the aetiology of external inflammatory resorption?
Necrotic pulp or other microbial infection
Periapical inflammatory lesion
Both contribute to IERR
What is the treatment for external inflammatory root resorption?
Remove the cause of the inflammation
Describe the pathogenesis of external replacement resorption after trauma has occured?
Injury to periodontum exposes external root dentine
Osteoclasts have direct access to these areas, leading to bone loss
Most common in avulsion and luxation injuries
